Document Detail


Diabetic retinopathy and coronary artery disease from the cardiac surgeon's perspective.
MedLine Citation:
PMID:  18222304     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Coronary artery disease is the leading cause of death in diabetics; therefore, the main purpose of managing coronary artery disease in diabetics should be to lengthen life expectancy. Recent evidence demonstrates that the severity of diabetic retinopathy is associated with a graded, increased risk of death from coronary artery disease and myocardial infarction. Recently, we found that the survival benefit of coronary artery bypass grafting over percutaneous coronary intervention is more apparent in patients with diabetic retinopathy than in diabetic patients without it. In this article, we review published studies evaluating the association between diabetic retinopathy and coronary artery disease, and we propose that coronary artery bypass surgery should be the first choice for revascularization of patients with diabetic retinopathy, especially in its early stage. Furthermore, coronary artery disease complicating diabetic retinopathy is often underdiagnosed, and all diabetic retinopathy patients should undergo screening for coronary artery disease followed by coronary artery bypass grafting. Future studies will probably comprise carefully performed cost-effective analyses of treatment effectiveness and prospective randomized studies comparing survival after coronary artery bypass grafting with that of survival after percutaneous coronary intervention, stratified by the stage of retinopathy.
Authors:
Takayuki Ohno; Shinichi Takamoto; Noboru Motomura
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  85     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-28     Completed Date:  2008-03-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  681-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiothoracic Surgery, The University of Tokyo, Tokyo, Japan. takohno-tky@umin.net
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Distribution
Aged
Comorbidity
Coronary Artery Bypass / methods*,  mortality
Coronary Disease / diagnosis,  epidemiology*,  surgery*
Diabetic Retinopathy / diagnosis,  epidemiology*,  surgery
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Risk Assessment
Severity of Illness Index
Sex Distribution
Survival Analysis
Thoracic Surgery
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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